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Relationship Between Adherence to Opioid Analgesics and Pain Beliefs Among Patients with Cancer Pain at Tertiary Care Hospitals in Malaysia

Authors Kan E, Mustafa S, Chong WW, Premakumar CM, Mohamed Shah N

Received 24 March 2020

Accepted for publication 20 June 2020

Published 12 August 2020 Volume 2020:14 Pages 1411—1419

DOI https://doi.org/10.2147/PPA.S255289

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Elaine Kan,1,2 Suzana Mustafa,1 Wei Wen Chong,2 Chandini Menon Premakumar,2 Noraida Mohamed Shah2

1Pharmacy Department, Kuala Lumpur Hospital, Ministry of Health, Kuala Lumpur, Malaysia; 2Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Correspondence: Noraida Mohamed Shah
Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
Tel +60 3 9289 8038
Email noraida_mshah@ukm.edu.my

Context: Pain is a common and distressing symptom among cancer patients. Opioid analgesics are the mainstay of cancer pain management, and adequate adherence plays an important role in achieving good pain control.
Purpose: To determine the level of adherence to opioid analgesics in patients with cancer pain and to identify factors that may influence the adherence.
Patient and Methods: This was a cross-sectional study conducted from March to June 2018 at two tertiary care hospitals in Malaysia. Study instruments consisted of a set of validated questionnaires; the Medication Compliance Questionnaire, Brief Pain Inventory and Pain Opioid Analgesic Beliefs─Cancer scale.
Results: A total of 134 patients participated in this study. The patients’ adherence scores ranged from 52– 100%. Factors with a moderate, statistically significant negative correlation with adherence were negative effect beliefs (rs= − 0.53, p< 0.001), pain endurance beliefs (rs = − 0.49, p< 0.001) and the use of aqueous morphine (rs = − 0.26, p=0.002). A multiple linear regression model on these predictors resulted in a final model which accounted for 47.0% of the total variance in adherence (R2 = 0.47, F (7, 126) = 15.75, p< 0.001). After controlling for other variables, negative effect beliefs were the strongest contributor to the model (β = − 0.39, p< 0.001) and uniquely explained 12.3% of the total variance.
Conclusion: The overall adherence to opioid analgesics among Malaysian patients with cancer pain was good. Negative effects beliefs regarding cancer pain and opioids strongly predicted adherence.

Keywords: beliefs, cancer pain, compliance, opioid analgesic

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